Current Urology Reports

, 20:41 | Cite as

Malone Antegrade Continence Enemas vs. Cecostomy vs. Transanal Irrigation—What Is New and How Do We Counsel Our Patients?

  • Maryellen S. KellyEmail author
Pediatric Urology (D Weiss, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pediatric Urology


Purpose of Review

No gold standard exists for managing neurogenic bowel dysfunction, specifically in individuals with spina bifida. Since the International Children’s Continence Society published its consensus document on neurogenic bowel treatment in 2012, an increased focus on why we must manage bowels and how to improve our management has occurred. This review provides updated information for clinicians.

Recent Findings

A surge in research, mostly retrospective, has been conducted on the success and satisfaction of three types of management for neurogenic bowel. All three management techniques have relatively high success rates for fecal continence and satisfaction rates. Selection of which treatment to carry out still is debated among clinicians.


Transanal irrigation is a safe and effective management option for neurogenic bowel that does not require surgery. Antegrade enemas can be carried out via cecostomy tube or Malone antegrade continence enema with similar fecal continence outcomes.


Neurogenic bowel Spina bifida Fecal incontinence Antegrade continence enemas Cecostomy Transanal irrigation 


Compliance with Ethical Standards

Conflict of Interest

Maryellen S. Kelly is on the advisory board for Coloplast A/C.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Urology, Department of SurgeryDuke University Medical CenterDurhamUSA

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